outside front cover COLORADO DEPARTMENT OF TRANSPORTATION PRE AND POST TRIP VEHICLE INSPECTION REPORT Month: Year: Vehicle number: CDOT Form #864 / print on tuck in flap Instructions DRIVERS: In those instances where a vehicle is driven by more than one driver in a twenty-four (24) hour period (eg. a snowplow being used all day), the following procedure should be adhered to: The driver whose shift is the first to start during that day (this is, after 12:01 AM) should complete the T PRE-TRIP inspection at the beginning of their shift, and the P POST TRIP at the end of that shift. A NEW form must be completed for each shift change that occurs. All drivers should indicate any problems they notice with the vehicle in both the T PRE-TRIP and P POST TRIP section of the inspection report, and initial any box they check. If necessary for clarification, put comments in the Remarks area regarding the nature of the defect, and whether that defect would be likely to affect the safe operation of the vehicle. The driver shall complete the Pre & Post Trip Vehicle Inspection Report and sign and date the report. (1) CDOT or their agent(s) shall certify on the report(s) that lists any defect(s) or deficiency(s) that the defect(s) or deficiency(s) were corrected or that correction is unnecessary before the vehicle is operated. (2) CDOT Field Offices shall retain the original copy of each vehicle inspection report and the certification of repairs for at least 3 months from the date the report was prepared. (3) A legible copy of the last vehicle inspection report, certified if required, shall be carried in the vehicle. MECHANICS: When the driver(s) identify defects, the mechanic must determine whether the defect(s) will cause a “vehicle outof-service” condition. a. If the mechanic determines that the defect(s) need not be corrected for the safe operation of the vehicle, then the mechanic will indicate this on the form and sign and date the report. b. If the mechanic determines that the defect(s) need repair before safe vehicle operation, then the mechanic will place the vehicle “Out-of-Service”, make appropriate repairs, and sign and date the report. Exemption. The rules in this section shall not apply to driveaway-towaway operations as specified in Sec. 396.15, or to any motor carrier operating only one vehicle Regulations... (Minimum requirements) Sec 396.11 Driver vehicle inspection report(s) (a) Report required. Every motor carrier shall require its drivers to report, and every driver shall prepare in writing at the completion of each day’s work on each vehicle operated and the report shall cover at least the following parts and accessories: Service brakes including trailer brake connections Parking (hand) brake Steering mechanism Lighting devices and reflectors Tires Emergency equipment Horn Windshield wipers Rear vision mirrors Coupling devices Wheels and rims (b) Report content. The report shall identify the motor vehicle and list any defect or deficiency discovered by or reported to the driver, which would affect safety of operation of the motor vehicle or result in its mechanical breakdown. If no defect or deficiency is discovered by or reported to the driver, the report(s) shall so indicate. In all instances, the driver shall sight the vehicle inspection report. On two-driver operations, only one driver needs to sign the report, provided both drivers agree as to the defects or deficiencies. If a driver operates more than one vehicle during the day, a report shall be prepared for each vehicle operated. (c) Corrective action. Prior to operating a motor vehicle, motor carriers or their agent(s) shall effect repair of any items listed on the vehicle inspection report(s) 396.13 Driver inspection Before driving a motor vehicle, the driver shall: (a) Be satisfied that the motor vehicle is in safe operating condition; (b) Review the last vehicle inspection report required to be carried on the power unit; and (c) Sign the report, only if defects or deficiencies were noted by the driver who prepared the report, to acknowledge that the driver has reviewed in and that there is a certification that the required repairs have been performed. The signature requirement does not apply to listed defects on a towed unit, which is no longer part of the vehicle combination. CDOT Form #864 / COLORADO DEPARTMENT OF TRANSPORTATION DRIVER’S VEHICLE INSPECTION REPORT In compliance with 49CFR 396.11&13 of the Federal Motor Carrier Safety Regulations Carrier: Colorado Department of Transportation Address: Zip code: City: q PRE-TRIP Date: Time: Odometer reading (miles): m POST TRIP Date: Time: Ending mileage: Starting mileage: Check any defective item and give details under “Remarks”. Check the q for Pre-Trip, and the m for Post Trip inspection. Bold items are red tag offenses recognized by FMCSR; repair before using vehicle. A. Tractor/Truck number: Vehicle preview q m Begin with a walk around using the previous Post Trip inspection Engine q m Fluid leaks q m All fluid levels q m Battery q m Transmission q m Radiator q m Engine q m Starter Cab q m Oil pressure q m Clutch q m Fire extinguisher q m Windshield q m Dash lights q m First aid kit q m Windows q m Wiper blades q m Mirrors q m Horn q m Spare bulbs & fuses q m All instrument gauges q m Triangles/flags/flares q m Heater/Defroster q m Seatbelts Walk-around qm qm qm qm Body Fuel tanks Tires Lug nuts Steps, handles Rear end Suspension system Exhaust system q m Back-up alarm q m Tire chains q m Muffler q m Front axle qm qm qm qm q m Warning lights q m Reflectors qm qm qm qm Coupling devices Fluid leaks Drive line Frame & assembly q m Mud flaps q m Tarpaulin q m Wheels and rims q m Steering Mechanism Lights q m Brake lights q m Head lights q m Turn signals Brake system q m Brake accessories q m Air lines q m Brake lining thickness ________________ q m Other: q m Parking brakes q m Air compressor q m Service brake q m Slack adjuster travel measurements ________________ B. Trailer(s) number(s): qm qm qm qm Brake connections Hitch Suspension system Attenuator bolts qm qm qm qm Starting mileage (from hub): Brakes Landing gear Wheels and rims Attenuator pins qm qm qm qm Tires Lights - all Lug nuts Other: q m Coupling device q m Doors q m Roof q m Tarpaulin q m Coupling (king) pin C. Aerial device - inspection of vehicle component is accomplished in the “Tractor/Truck” section: qm qm qm qm Fluid leaks q m Fasteners q m All fluid levels Outriggers q m Hydraulic system q m Retaining pins Fiberglass extension q m Safety belts & straps Test bucket lift controls q m Other: q m Power take-off q m Liner q m Welds q m Bucket q m Test ground controls Remarks: q m CONDITION OF THE ABOVE VEHICLE IS SATISFACTORY Pre-trip driver’s printed name: Post trip driver’s printed name: Pre-trip driver’s signature: Post trip driver’s signature: q m ABOVE DEFECTS NEED NOT BE CORRECTED FOR SAFE OPERATION OF THE VEHICLE q m ABOVE DEFECTS CORRECTED Mechanic’s signature: White - File copy Yellow - Driver’s copy Date: Driver’s signature: Date: CDOT Form #864 5/13